Lactoferrin as Antiviral Treatment in COVID-19 Management: Preliminary Evidence

Abstract

Lactoferrin (Lf), a multifunctional cationic glycoprotein synthesized by exocrine glands and neutrophils, possesses an in vitro antiviral activity against SARS-CoV-2. Thus, we conducted an in vivo preliminary study to investigate the antiviral effect of oral and intranasal liposomal bovine Lf (bLf) in asymptomatic and mild-to-moderate COVID-19 patients. From April 2020 to June 2020, a total of 92 mild-to-moderate (67/92) and asymptomatic (25/92) COVID-19 patients were recruited and divided into three groups. Thirty-two patients (14 hospitalized and 18 in home-based isolation) received only oral and intranasal liposomal bLf; 32 hospitalized patients were treated only with standard of care (SOC) treatment; and 28, in home-based isolation, did not take any medication. Furthermore, 32 COVID-19 negative, untreated, healthy subjects were added for ancillary analysis. Liposomal bLf-treated COVID-19 patients obtained an earlier and significant (p < 0.0001) SARS-CoV-2 RNA negative conversion compared to the SOC-treated and untreated COVID-19 patients (14.25 vs. 27.13 vs. 32.61 days, respectively). Liposomal bLf-treated COVID-19 patients showed fast clinical symptoms recovery compared to the SOC-treated COVID-19 patients. In bLf-treated patients, a significant decrease in serum ferritin, IL-6, and D-dimers levels was observed. No adverse events were reported. These observations led us to speculate a potential role of bLf in the management of mild-to-moderate and asymptomatic COVID-19 patients.

Keywords: COVID-19; D-dimers; IL-6; SARS-CoV-2; bovine lactoferrin; ferritin; liposomal bovine lactoferrin.

Figure 1

CONSORT diagram of the clinical trial. BLf = bovine lactoferrin; SOC = standard of care.

Figure 2

A total of 92 patients with confirmed COVID-19 infection at reverse transcriptase real time (rRT)-PCR were recruited to participate in this study. Patients were divided into three groups according to the administered treatment. Thirty-two patients were treated with liposomal bovine lactoferrin (bLf); another 32 patients received a standard of care (SOC) regimen; while 28 patients did not receive any treatment against COVID-19. As a control group, 32 healthy volunteers with negative COVID-19 infection at rRT-PCR naso-oropharyngeal swab were recruited.